Playing catch-up with health insurance

Long before the nation had the Affordable Care Act (Obamacare), federal workers, including elected and appointed U.S. government officials, had the Federal Employees Health Benefits Program. Many believe the FEHBP was the model for the ACA.

In the past, many private-sector employers didn’t offer health insurance to employees. Of those that did, many gave workers very limited choices and sometimes reduced benefits or boosted premiums (or both) when people retired.

While many feds find fault with the FEHBP, most nonfederal workers would be happy with the coverage, options and premium sharing deal in which the government pays about 70 percent of the total premium. Postal workers get an even better deal thanks to their union contract, which requires the USPS to pay even more of the total premium.

One of the arguments for health care reform, such as the ACA, was that ordinary Americans deserved the same coverage that is available to members of Congress (who are also under the FEHBP). They pay the same premiums and get the same coverage as rank-and-file feds in the same plans, except that representatives and senators do get VIP suites and treatment at several major military facilities like the old Bethesda Naval Hospital and Walter Reed.

In many instances, the incredibly complicated ACA law is based on the FEHBP program — except for the premium sharing.

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Walton Francis, editor of the Checkbook’s Guide To Federal Health Plans says everybody in the program should consider its positive strong points during the open enrollment period that ends Dec. 10. Among them:

All employees, retirees and survivors can enroll in any plan they choose.

Everyone can change plans once a year (during the Open Season) or at any other time if they get married, divorced, are widowed or have adopted a child. Children can be covered in a family plan up to age 26.

If dependent children are seriously handicapped, they can be covered for life as part of a family plan, regardless of age.

Long before the ACA, the federal program barred FEHBP-participating plans from rejecting eligible workers and retirees because of preexisting medical conditions, age, sex, general health or lifestyle. As Francis says, “You may switch plans to gain the best coverage for your condition, and use the new plan without penalty.”

If you are nearing the lifetime limit of payment in your current health plan, you can switch to any of more than a dozen national fee-for-service plans, or to HMOs in your area.

Benefits are not reduced and premiums do not increase once a participant in the FEHBP retires or hits a certain age.

Moustafa Ismail, dubbed the Egyptian Popeye for his 31-inch biceps, eats seven pounds of protein, nine pounds of of carbohydrates and three gallons of water to maintain the world’s biggest arms, according to the Guinness Book of World Records. Sadly, he’s not a fan of spinach.